Abstract

Background

Cervical cancer is the most common malignant gynecological cancer, and lymphatic metastasis
can occur in the early stage of tumor growth. Lymphatic vessel endothelial hyaluronan
receptor-1 (LYVE-1), a marker for lymphatic endothelium, provides powerful tools for
studying tumor lymphangiogenesis. The purpose of this study is to investigate the
clinical implications of lymphangiogenesis in the metastasis of early-stage invasive
cervical carcinoma.

Methods

We used immunohistochemical (IHC) staining with the antibody against LYVE-1 to measure
lymph vessel density in 41 cases of early-stage invasive cervical carcinoma and 12
cases of normal cervical samples. We then analyzed the correlation between lymph vessel
density and clinicopathological features of the tumors.

Results

(1) The majority of peritumoral lymphatics were enlarged, dilated, and irregular.
In contrast, intratumoral lymph vessels were small and collapsed. The peritumoral
lymphatic vessel density (PLVD) was significantly higher than the intratumoral lymphatic
vessel density (ILVD) (P < 0.01). (2) Both ILVD and PLVD were significantly higher than the LVD of the control
cervixes (P < 0.01). (3) Both ILVD and PLVD were significantly associated with lymph node metastasis
(ILVD, P < 0.05; PLVD, P < 0.01) and lymphatic vessel invasion (ILVD, P < 0.05; PLVD, P < 0.01). Both the ILVD and PLVD in patients with histological grade HG2 and HG3 were
significantly higher than those with HG1 (P < 0.05).

Conclusion

Tumor lymphangiogenesis in early-stage invasive cervical carcinoma may play an important
role in the process of lymphatic metastasis.